Psoriatic arthritis is a strong predictor of sleep interference in patients with psoriasis
ABSTRACT We sought to determine what clinical features of psoriasis predict sleep interference.
Data were obtained from 420 respondents to the 2005 National Psoriasis Foundation telephone and e-mail surveys. Logistic regression was used to determine whether disease severity, body mass index, age of onset, psoriatic arthritis, income, ethnicity, sex, current therapy, and quality-of-life measures predicted reported sleep interference within the last month.
Psoriatic arthritis was the most significant predictor of sleep disturbance (odds ratio = 3.26). Itch, pain of lesions, and impact on emotional well-being were also significant predictors (odds ratio 1.26, 1.22, and 1.18, respectively). Body surface area covered with psoriasis, body mass index, and therapy were not significant predictors of sleep interference.
All data were self-reported and not physician-assessed.
History of psoriatic arthritis, presence of itch and pain of psoriatic lesions, and impact of psoriasis on overall emotional well-being predict sleep interference.
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ABSTRACT: Steatocystoma multiplex is primarily an inherited condition:however many cases have been reported where there is no apparent inheritance pattern. This desease is characterized yellow to white papules and cysts that tend to develop on the arms, chest, axillae, neck and scrotum..They can range in size from 2mm to 2cm.When squeezed the cysts exude a yellow to white tenacious fluid. Treatment for lesions has included surgical excision or drainage,oral retinoids and liquid nitrogen cryotherapy. Key words: Polycystic Disease. dermal cysts, Steatocystoma multiplex.Medicus 06/2006; V((1)):107-110.
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ABSTRACT: Poor sleep quality adversely affects quality of life in patients with psoriasis. However, the factors impairing sleep in these patients have not been well described. We reviewed the available literature linking sleep quality and psoriasis to elucidate factors that interfere with sleep. Pruritus, depression, pain, and obstructive sleep apnea may be likely sources of sleep impairment in patients with psoriasis. Fatigue resulting from sleep interference may also be implicated in this relationship. Pruritus, depression, and pain interfere with sleep quality by increasing nocturnal awakenings and sleep fragmentation. Obstructive sleep apnea may occur in a greater percentage of patients with psoriasis than control populations. Factors associated with psoriasis appear to have similarities in their cytokine and neuropeptide profiles. Moreover, these variables are complex and interconnected. Further study and awareness of potential factors impacting sleep in patients with psoriasis may provide new avenues for treatment of recalcitrant disease.Journal of the American Academy of Dermatology 11/2009; 63(1):114-23. DOI:10.1016/j.jaad.2009.07.003 · 4.45 Impact Factor
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ABSTRACT: We have long assumed that rheumatic pain causes sleep problems, fatigue, and functional disability. This paper reviews the accumulating evidence from human and animal experimental research studies that show a bidirectional relationship of disordered sleep to pain and fatigue. The studies demonstrate that both disturbances of sleep and sleep restriction result in increased sensitivity to noxious stimuli and musculoskeletal pain symptoms. The notion of central nervous system hypersensitivity affecting widespread pain in patients with fibromyalgia syndrome is the result of a reduction in neurophysiologic inhibition of perception of noxious stimuli that is provoked by disordered sleep. Clinical and epidemiological studies show that sleep disturbances directly influence musculoskeletal pain, fatigue, mood, and overall well-being. Indeed, the interrelationships of the sleeping/waking brain with cytokine and cellular immune functions have important implications for the understanding of rheumatic disease pathology and management with disease-modifying antirheumatic drugs. The determination of how disordered sleep affects musculoskeletal pain, fatigue, mood, and behavior is important in the assessment and management of patients with rheumatic illness. The high prevalence of obstructive sleep apnea and restless legs syndromes requires more research to determine whether treatments of these sleep disorders will benefit the symptoms of rheumatic diseases.Current opinion in rheumatology 01/2010; 22(1):59-63. DOI:10.1097/BOR.0b013e328333b9cc · 4.89 Impact Factor